What Is Atherosclerosis?

Atherosclerosis causes plaque to clog and narrow your arteries over time.

Atherosclerosis causes plaque to build up in your arteries. Those are the tubes that carry oxygen-rich blood from your heart to other organs. Over time, this plaque thickens, hardens, and narrows your arteries. When this happens, your organs can’t get the oxygen they need. 

Plaque is a mixture of several different substances in your blood, including:

• Fat
• Cholesterol
• Cell waste
• Calcium
• Fibrin (a material that helps with clotting)

When plaque completely blocks the blood flow in an artery, it can cause a stroke or heart attack. What follows is information that can help you understand this serious condition, what the risks are, and how to take care of yourself or someone close to you. 

You may not know you have atherosclerosis until the plaque is so thick that blood can’t get through your artery. Clogged arteries in different places in your body will cause different symptoms:  

• Heart -- chest pain and pressure, which can lead to a heart attack
• Brain -- sudden numbness, trouble talking, slurred speech, limb weakness, drooping facial muscles, vision loss (all of which can be signs of a stroke or a transient ischemic attack [TIA], which can lead to a stroke)
• Arm or leg arteries -- pain when you walk or use your arms
• Kidneys -- high blood pressure, kidney failure

Atherosclerosis develops slowly over time. It can start as early as childhood. Doctors aren’t sure exactly what causes it. They think it may start when you get an injury to the inner layer of your artery. You might get this damage from:

• High blood pressure
• High cholesterol
• High triglycerides (a type of fat in your blood)
• Smoking
• High blood sugar
• Inflammatory conditions such as lupus, arthritis, or infection

Plaque clumps up at the site of the injury. It then begins to thicken.

The older you get, the more time plaque has to build up. That’s why the chances you’ll get atherosclerosis go up as you age. Other conditions and lifestyle factors can also raise your risk. They include:

• High LDL cholesterol and low HDL cholesterol
• High blood pressure
• Smoking
• High blood sugar
• Obesity
• Not exercising
• Poor diet
• Family history of heart disease

If your doctor thinks you have atherosclerosis, she will ask for your complete medical history. She’ll also do a physical exam, listen to your heart and arteries, and check your blood pressure. 

You may also need one or more tests. Doctors use several tests to help diagnose atherosclerosis:

• Blood test: Your doctor looks at the sugar and cholesterol levels in your blood to see if they are higher than they should be.
• Cardiac catheterization: A doctor puts a long, thin tube into the arteries around your heart and injects dye into them. The dye allows the doctor to see on an X-ray the path blood takes through the arteries and which ones are narrow or blocked.
• Doppler ultrasound: A Doppler device sends sound waves through blood vessels in your neck, abdomen, or legs. The sounds (or lack of sound) can tell doctors whether you have a blockage.
• Blood pressure comparison: Your doctor checks the blood pressure in your arms and legs. If the readings are different, it can be a sign of the disease.
• Electrocardiogram (ECG): This test (also called EKG) records the timing and strength of electric signals as they travel through your heart. The results help your doctor see if you have damage to your heart muscle or if you've had or are having a heart attack.
• Stress test:  Your doctor monitors your heartbeat and breathing while you walk on a treadmill or ride a stationary bike. This can reveal signs of disease.
• Imaging tests: Computerized tomography (CT) scan or magnetic resonance angiography (MRA) can create different kinds of images of your arteries that doctors study for narrowing or blockages.

Your treatment will depend on which arteries have blockages and the symptoms you have as a result. You may need medicines, such as: 

• Antiplatelet medicines that prevent blood from clotting
• Anticoagulants or blood thinners that also keep blood clots from forming
• Cholesterol-lowering medication
• Blood pressure medication

In some cases, you may need a procedure or surgery, such as:

• Balloon angioplasty -- A small balloon inflated inside your blocked artery to open it
• Atherectomy -- A procedure to shave away plaque inside the artery
• Laser angioplasty -- Lasers that blast away plaque 
• Coronary artery stent -- A tiny coil expanded inside your blocked artery to allow blood to flow through

If the blocked artery is in your heart, you may need a surgery called coronary artery bypass. In this surgery, doctors take a piece of healthy artery and attach it to the blocked artery. Blood flows through this detour instead of the blocked area.

You can’t change your age or family history. Both can raise the risk of atherosclerosis. But you can take other steps to lower your risk for this disease such as:

• Don’t smoke.
• Eat a high-fiber diet, low in cholesterol, fat, and sodium.
• Get regular exercise.
• Take control of other conditions that can contribute to the disease, such as diabetes, high cholesterol, or high blood pressure.